可吸收手术缝合线研究进展

doi:10.13475/j.fzxb.20221102502

纺织学报 ›› 2024, Vol. 45 ›› Issue (01): 230-239.doi: 10.13475/j.fzxb.20221102502

可吸收手术缝合线研究进展

杨智超, 刘淑强, 吴改红, 贾潞(), 张曼, 李甫, 李慧敏

太原理工大学轻纺工程学院, 山西太原 030024

收稿日期:2022-12-01 修回日期:2023-11-10 出版日期:2024-01-15 发布日期:2024-03-14
通讯作者: 贾潞(1990—),女,讲师。主要研究方向为纺织品的功能化及智能化应用。E-mail: jialu@tyut.edu.cn。
作者简介:杨智超(1998—),男,硕士生。主要研究方向为生物医用材料。
基金资助:
山西省基础研究计划项目(20210302123114);山西省基础研究计划项目(202203021211146);山西省科技成果转化引导专项项目(202104021301053);山西省社科联2021年度重点课题(SSKLZDKT2021025);山西省高等学校大学生创新创业训练计划项目(20220125);山西省基础研究计划(青年)(20210302124684)

Research progress in absorbable surgical sutures

YANG Zhichao, LIU Shuqiang, WU Gaihong, JIA Lu(), ZHANG Man, LI Fu, LI Huimin

College of Textile Engineering, Taiyuan University of Technology, Taiyuan, Shanxi 030024, China

Received:2022-12-01 Revised:2023-11-10 Published:2024-01-15 Online:2024-03-14

摘要/Abstract

摘要：

可吸收手术缝合线是当今国际生物医用纺织领域的研究热点之一。为了掌握可吸收手术缝合线的创新方向以及临床和产业化需求提升我国可吸收手术缝合线的自主知识产权;首先介绍了可吸收缝合线的发展历程以及性能要求;其次列举了羊肠线、胶原线、甲壳质和海藻酸盐4种天然材料在天然可吸收缝合线方面的应用并总结分析最新国内外相关研究;然后综述了聚乳酸、聚乙醇酸、聚己内酯和聚乙烯醇4类合成高分子材料在可吸收缝合线方面的应用并总结分析国内外最新相关研究;系统对比了各种制备原料开发可吸收手术缝合线的优缺点,并侧重分析了可吸收手术缝合线的力学性能、降解性能以及附加抗菌性能3个重要指标。分析认为:目前市面上的可吸收手术缝合线仍以国外进口为主导,我国对于可吸收手术缝合线的开发仍处于实验室阶段,较少能够投入市场以及临床应用,另外,对用天然材料开发的可吸收手术缝合线研究甚少。同时,提出各类材料作为可吸收手术缝合线的优缺点,为新型可吸收手术缝合线的开发提供参考。

关键词: 生物医用纺织品, 可吸收手术缝合线, 天然材料, 合成高分子材料, 降解性能, 抗菌性能

Abstract:

Significance Biomedical textiles are one of the most innovative and technologically advanced research fields in the textile industry today. Surgical sutures are one of the most used medical devices in clinical surgery, and research and development of sutures have been active worldwide. As a new generation of surgical sutures, absorbable surgical sutures are the ″darling″ of the medical community, with extremely important applications in obstetrics and gynecology, surgery, otolaryngology, ophthalmology, dentistry, and so on. Absorbable surgical sutures have become the first choice of surgeons in surgical procedures by virtue of their self-degrading, non-removable and less painful properties, and patients using absorbable surgical sutures are benefitted from having minimal visible scarring on the skin after healing, enhancing patient satisfaction. Although the development of absorbable surgical sutures is now at a relatively mature stage, many high value-added absorbable surgical sutures with excellent functionality are still in the laboratory stage and cannot be industrially produced and marketed for clinical applications. Therefore, this paper focuses on the analysis of various raw materials for preparation of absorbable surgical sutures based on the latest relevant research literature to systematically summarize the current research status of absorbable surgical sutures, promote the innovative development of absorbable surgical sutures and enhance the industrial production of absorbable surgical sutures.

Progress The development of absorbable sutures and their performance requirements, the history of the development of absorbable surgical sutures from ancient times to the present day are introduced first. The development of the raw materials for their preparation from single to diversified are elaborated. The specific development history is shown, and the mainstream products on the market today are shown. In addition, the properties of absorbable surgical sutures, such as good biocompatibility and good knot strength, as well as the smoothness of the suture surface, are systematically reviewed. The four natural materials used for natural absorbable suture applications, namely catgut, collagen, chitin and alginate, are scutinised and the latest research in this area is summarized and analyzed. Four types of synthetic polymers, i.e., polylactic acid, polyglycolic acid, polycaprolactone and polyvinyl alcohol, are reviewed for making absorbable sutures and the latest research is summarized and analyzed. The advantages and disadvantages of developing absorbable surgical sutures from various materials are systematically studied and compared, and the analysis focused on three important indicators which are the mechanical properties, degradation properties and additional antibacterial properties of absorbable sutures. The overview of antimicrobial immune novel absorbable surgical sutures is also summarized the relevant mechanisms of action is described. Finally, the article concludes with an analysis and summary of the problems of today's absorbable surgical sutures and the trends of future development.

Conclusion and Prospect The paper analyzes the current status of research on surgical sutures in recent years, starting from the materials used for the preparation of absorbable sutures. The technology for the development of absorbable surgical sutures is becoming more mature, but some problems still need research attention. 1) Relatively little research has been conducted on natural type of absorbable surgical sutures, and the initial catgut have disadvantages such as poor mechanical properties and tendency to trigger tissue reactions, which require further modification of the material. Chitin is commonly used as a functional coating finishing material to impart antimicrobial properties in recent years due to its excellent broad-spectrum antibacterial properties, but little research has been conducted on the preparation of sutures using chitin fibers for development. 2) The development of synthetic polymeric materials has provided more possibilities for the preparation of new absorbable surgical sutures. However, the degradation cycles of various materials are different, resulting in a mismatch between wound healing time and suture degradation time, which affects wound healing. Therefore, the controlled degradation of synthetic polymers is particularly important, so the research of absorbable sutures made of synthetic polymers should be enhanced in terms of the regulation of degradation properties. 3) Wound infection is a persistent problem in surgical procedures, and therefore the development of absorbable surgical sutures with excellent antimicrobial properties is the main theme in suture preparation. Tthe selection of suitable antimicrobial agents, the enhancement of antimicrobial agent loading fastness, and the long-lasting and stable action of antimicrobial agents are issues requiring future research attention.

Key words: biomedical textile, absorbable surgical suture, natural material, synthetic polymer, degradation performance, antibacterial property

中图分类号:

TS102.5

杨智超, 刘淑强, 吴改红, 贾潞, 张曼, 李甫, 李慧敏. 可吸收手术缝合线研究进展[J]. 纺织学报, 2024, 45(01): 230-239.

YANG Zhichao, LIU Shuqiang, WU Gaihong, JIA Lu, ZHANG Man, LI Fu, LI Huimin. Research progress in absorbable surgical sutures[J]. Journal of Textile Research, 2024, 45(01): 230-239.

图/表 2

表1

表2

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时间	材料
公元前1800年~1500年	肠线^[8?-10]
19世纪末	消毒的肠线^[8?-10]
20世纪60年代	可控制体内吸收速率的胶原线^[11-12]
20世纪70年代	甲壳素可吸收缝合线^[8?-10]
19世纪90年代末	海藻酸盐纤维^[11]
20世纪60年代	PGA可吸收缝合线^[11-12]
20世纪60年代末	PPDO缝合线的开发^[8?-10]
20世纪70年代初	PLLA纤维^[11-12]
20世纪70年代末~80年代	PDS缝合线和Maxon^[8?-10,12]
20世纪90年代	PLA缝合线及相关改性处理^[8?-10,12]
20世纪90年代末	PDO缝合线^[12]

商品名称	年份	材质	功能	应用领域
Vicryl^?缝合线(爱惜康)	1974年	聚糖乳酸910(乙交酯与丙交酯)	用于组织的闭合处理	眼科手术、软组织缝合或结扎
PDS^?Ⅱ缝合线	1982年	聚对二氧环己酮聚合物(PPDO)	用于软组织缝合	小儿心血管手术和眼科手术
Monocryl^?缝合线	1993年	聚卡普隆25(75%聚乙交酯和25%ε-己内酯)	用于软组织缝合	软组织缝合和结扎,不能用于显微外科手术
古氏SA+抗菌线	2016年	乙交酯-左旋丙交酯共聚物	用于各类组织缝合	皮下组织缝合、胃肠道手术以及血管手术
Velosorb^TM快速编织缝合线(柯惠)	—	乙交酯和丙交酯组成	用于组织的闭合处理	皮肤和黏膜的软组组织闭合
Biosyn^TM单丝缝合线 (柯惠)	—	由乙交酯、二氧环己酮以及三亚甲基碳酸脂组成	用于软组织的闭合处理	适用于眼科以及皮肤黏膜的结扎处理
MONOCRYL^* Plus抗菌缝合线(爱惜康)	—	乙交酯和25%ε-己内酯,外加三氯生涂层	用于软组织的闭合处理	适用于皮肤黏膜结扎处理,不适用眼科以及神经组织手术

可吸收手术缝合线研究进展

Research progress in absorbable surgical sutures

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